Left Ventricular Assist Device Design Reduces von Willebrand Factor Degradation: A Comparative Study Between the HeartMate II and the EVAHEART Left Ventricular Assist System

Bartoli, Carlo; Kang, Jooeun; Zhang, David M.; Howard, Jessica; Acker, Michael A.; Atluri, Pavan; Motomura, Tadashi

doi:10.1016/j.athoracsur.2016.06.112

Cited by 47 publications

(52 citation statements)

References 30 publications

(65 reference statements)

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“…11 Centrifugal-flow left VADs (LVADs) seem to induce less VWF degradation and hemolysis than axial-flow LVADs and biventricular assist devices (BVADs). 11,12 The HeartMate II (HM II) is an axial continuous-flow LVAD implanted into 15 000 patients worldwide. 13 The HeartMate III (HM III) is a novel LVAD featuring several modifications and potential improvements compared with its predecessor.…”

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Platelet secretion defects and acquired von Willebrand syndrome in patients with Ventricular Assist Devices

et al. 2019

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Background--The number of implanted ventricular assist devices (VADs) has increased significantly recently. Bleeding, the most frequent complication, cannot be solely attributed to anticoagulation therapy. Acquired von Willebrand syndrome (AVWS) caused by increased shear stress is frequent in VAD patients and can increase the bleeding risk. The HeartMate III (HM III) is a novel left VAD featuring potential improvements over the HeartMate II.Methods and Results--In this study, we investigated the prevalence and onset of AVWS in 198 VAD patients. To our knowledge, this is the largest cohort of VAD patients whose longitudinal data on AVWS have been collected. We also analyzed whether AVWS is less severe in HM III patients than in HeartMate II patients. Because platelet dysfunction can raise the bleeding risk, we investigated platelet function in a subset of patients. In total, 198 VAD patients and 60 patients with heart transplants as controls were included in this study. The ratio of von Willebrand factor collagen binding capacity to von Willebrand factor:antigen, multimer analyses, and platelet function (especially secretion of aand d-granules) were investigated. All 198 VAD patients developed AVWS. As soon as the VAD was explanted, the AVWS disappeared within hours. AVWS was less severe in the HM III patients than in the HeartMate II patients. The HM III patients had fewer bleeding symptoms. In addition, VAD patients exhibited a platelet aand d-granule secretion defect.Conclusions--AVWS develops in VAD patients and may increase the bleeding risk. The HM III device causes less severe AVWS. Platelet secretion defects should be investigated in VAD patients because they also raise the bleeding risk.Clinical Trial Registration--https://www.drks.de/drks_web.

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Platelet secretion defects and acquired von Willebrand syndrome in patients with Ventricular Assist Devices

et al. 2019

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“…Important parameters of the NSGA-II operators (7) s,ratio = s s,b (8) minimize: In this method, the search is started with the random generation of an initial population in the search space.…”

Section: Algorithmmentioning

confidence: 99%

“…Those steps are iteratively generated new population from existing ones, until converging requirement is reached. Important parameters of the NSGA-II operators (7) s,ratio = s s,b (8) minimize:…”

Section: Algorithmmentioning

confidence: 99%

“…For typical gap sizes, those high shear regions result in the release of red blood cell (RBC) hemoglobin into the surrounding fluid (blood plasma), which is well known as hemolysis. Furthermore, an increased shear stress may lead to platelet activation and acquired von Willebrand disease (6)(7)(8)(9). Furthermore, an increased shear stress may lead to platelet activation and acquired von Willebrand disease (6)(7)(8)(9).…”

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confidence: 99%

“…However, for very small gap sizes (~50 μm), RBCs may be excluded from the clearance gap providing an almost normal clinical level of hemolysis (5). Furthermore, an increased shear stress may lead to platelet activation and acquired von Willebrand disease (6)(7)(8)(9).…”

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Multi‐Objective Genetic Algorithm Assisted by an Artificial Neural Network Metamodel for Shape Optimization of a Centrifugal Blood Pump

et al. 2018

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A centrifugal blood pump is a common type of the pump used as a left ventricular assist device (LVAD) in the medical industries. The reduction of the LVADs hemolysis level to reduce the blood damage is one of the major concerns in designing of such devices. Also, the enhancement of the LVADs efficiency to decrease the battery size is another design requirement. The blood damage critically depends on the state of the blood being pumped. Besides the blood state, the blood damage also depends on the pump impeller and volute geometries. In this research, a multi-objective optimization of a centrifugal blood pump is performed. A complete 3D-optimization platform is established for both impeller and volute of a centrifugal blood pump consisting of parametric modeling, automatic mesh generation, computational fluid dynamics (CFD) simulation, and optimization strategy. A

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LVAD‐Associated Acquired von Willebrand Syndrome and Gastrointestinal Bleeding: Pathophysiology, Etiologies, and Management

Ramdeen,

Bartoli

2023

Textbook of Transplantation and Mechanical Support for End‐Stage Heart and Lung Disease

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Left Ventricular Assist Device Design Reduces von Willebrand Factor Degradation: A Comparative Study Between the HeartMate II and the EVAHEART Left Ventricular Assist System

Abstract: The EVAHEART LVAS caused significantly less vWF degradation than the HeartMate II in a mock circulatory loop with whole human blood. LVAD design features may minimize vWF degradation. These data may inform the design and operation of next-generation LVADs to minimize blood trauma.

Cited by 47 publications

References 30 publications

Platelet secretion defects and acquired von Willebrand syndrome in patients with Ventricular Assist Devices

Platelet secretion defects and acquired von Willebrand syndrome in patients with Ventricular Assist Devices

Multi‐Objective Genetic Algorithm Assisted by an Artificial Neural Network Metamodel for Shape Optimization of a Centrifugal Blood Pump

LVAD‐Associated Acquired von Willebrand Syndrome and Gastrointestinal Bleeding: Pathophysiology, Etiologies, and Management

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